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急性期糖蛋白标志物糖化白蛋白(GlycA)与2型糖尿病发病风险:荷兰预防和早期糖尿病肾病研究(PREVEND研究)

GlycA, a marker of acute phase glycoproteins, and the risk of incident type 2 diabetes mellitus: PREVEND study.

作者信息

Connelly Margery A, Gruppen Eke G, Wolak-Dinsmore Justyna, Matyus Steven P, Riphagen Ineke J, Shalaurova Irina, Bakker Stephan J L, Otvos James D, Dullaart Robin P F

机构信息

LipoScience, Laboratory Corporation of America® Holdings, Raleigh, NC, United States.

Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands; Department of Nephrology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Clin Chim Acta. 2016 Jan 15;452:10-7. doi: 10.1016/j.cca.2015.11.001. Epub 2015 Nov 5.

Abstract

BACKGROUND

GlycA is a recently developed glycoprotein biomarker of systemic inflammation that may be predictive of incident type 2 diabetes mellitus (T2DM).

METHODS

Analytical performance of the GlycA test, measured on the Vantera® Clinical Analyzer, was evaluated. To test its prospective association with T2DM, GlycA was measured in 4524 individuals from the PREVEND study and a survival analysis was performed with a mean follow-up period of 7.3y.

RESULTS

Imprecision for the GlycA test ranged from 1.3-2.3% and linearity was established between 150 and 1588μmol/l. During the follow-up period, 220 new T2DM cases were ascertained. In analyses adjusted for relevant covariates, GlycA was associated with incident T2DM; hazard ratio (HR) for the highest vs. lowest quartile 1.77 [95% Confidence Interval (CI): 1.10-2.86, P=0.01], whereas the association of high sensitivity C-reactive protein (hsCRP) with T2DM was not significant. GlycA remained associated with incident T2DM after additional adjustment for hsCRP; HR 1.71 [1.00-2.92, P=0.04]. A multivariable adjusted analysis of dichotomized subgroups showed that the hazard for incident T2DM was highest in the subgroup with high GlycA and low hsCRP (P=0.03).

CONCLUSIONS

The performance characteristics of the GlycA test reveal that it is suitable for clinical applications, including assessment of the risk of future T2DM.

摘要

背景

糖化白蛋白(GlycA)是一种最近开发的全身性炎症糖蛋白生物标志物,可能预测2型糖尿病(T2DM)的发生。

方法

评估了在Vantera®临床分析仪上检测的GlycA检测的分析性能。为了测试其与T2DM的前瞻性关联,在来自预防糖尿病和血管疾病研究(PREVEND)的4524名个体中测量了GlycA,并进行了平均随访期为7.3年的生存分析。

结果

GlycA检测的不精密度范围为1.3%-2.3%,在150至1588μmol/l之间建立了线性关系。在随访期间,确定了220例新的T2DM病例。在对相关协变量进行调整的分析中,GlycA与T2DM的发生相关;最高四分位数与最低四分位数的风险比(HR)为1.77[95%置信区间(CI):1.10-2.86,P=0.01],而高敏C反应蛋白(hsCRP)与T2DM的关联不显著。在对hsCRP进行额外调整后,GlycA仍与T2DM的发生相关;HR为1.71[1.00-2.92,P=0.04]。对二分亚组进行多变量调整分析显示,在GlycA高且hsCRP低的亚组中,T2DM发生的风险最高(P=0.03)。

结论

GlycA检测的性能特征表明它适用于临床应用,包括评估未来发生T2DM的风险。

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